Orbital Fracture

Orbital Fracture

• Introduction //
• Care

Orbital fractures are commonly seen with midfacial trauma. Fractures may be limited to the internal orbital skeleton. This type includes blow-out and blow-in patterns, as seen in isolated fractures of the orbital floor, medial wall, and roof.Fractures may involve the orbital rim. An inferior, lateral, or superior rim fracture may be an isolated injury, or it may be contiguous with an internal-wall fracture.Fractures may be associated with other fractures of the facial skeleton. Orbit involvement is seen in various facial fracture patterns, including zygomaticomaxillary (ZMC), naso-orbito-ethmoid (NOE), frontal-sinus, Le Fort II, and Le Fort III fracture patterns.

The aim of orbital reconstruction is to achieve normal bony projection, to reposition the globe, to release any entrapped orbital soft tissue, and to reconstitute normal orbital volume.

• Treatment: Patients should avoid blowing their nose and performing Valsalva maneuvers to limit intraorbital emphysema. Visual loss with acute orbital emphysema has been reported. Oral antibiotic therapy may be considered. Fractures that involve the medial wall and floor may be considered open fractures, as laceration of the sinus mucosa is inevitable. Analgesia and antiemetics may be required.